Which of the following is seen in nephrotic syndrome: March 2013
**Core Concept**
Nephrotic syndrome is characterized by a complex interplay of pathophysiological mechanisms leading to massive proteinuria, hypoalbuminemia, hyperlipidemia, and edema. The primary defect is the disruption of the glomerular filtration barrier, allowing large molecules like albumin to escape into the urine.
**Why the Correct Answer is Right**
The correct answer is related to the increased synthesis of lipoproteins in response to hypoalbuminemia. When albumin levels drop, the liver increases the production of lipoproteins, particularly VLDL (Very Low-Density Lipoprotein), to help maintain oncotic pressure. This leads to an increase in total cholesterol and triglyceride levels in the blood. The liver also produces more lipoproteins to compensate for the loss of albumin in the urine, further contributing to hyperlipidemia.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not directly related to nephrotic syndrome. While proteinuria is a hallmark of the condition, it is not a direct cause of increased lipoprotein synthesis.
**Option B:** This option is incorrect because nephrotic syndrome is not characterized by an increase in serum calcium levels. In fact, hypercalcemia is not a typical finding in nephrotic syndrome.
**Option C:** This option is not seen in nephrotic syndrome. While hyperkalemia can occur in various renal disorders, it is not a characteristic feature of nephrotic syndrome.
**Clinical Pearl / High-Yield Fact**
In nephrotic syndrome, the liver's response to hypoalbuminemia can lead to an increase in lipoprotein synthesis, resulting in hyperlipidemia. Remember that the liver's primary goal is to maintain oncotic pressure, and it compensates for the loss of albumin by increasing lipoprotein production.
**Correct Answer: D. Hyperlipidemia**